Infection Control Today

NOV 2018

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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16 ICT November 2018 www.infectioncontroltoday.com feature O ne of the key interventions in occupational health is vaccination, particularly to protect against influenza. Flu among healthcare personnel (HCP) can result in lost workdays and can spread to other workers and to patients who are at signifi cant risk of serious fl u complications. Flu vaccination of HCP has been shown to reduce the risk of fl u and absenteeism in vaccinated HCP and reduce the risk of respiratory illness and deaths. While we won't know what the vaccine coverage for healthcare workers was for 2018 until next year, the Centers for Disease Control and Prevention (CDC) reported that last season, 67.6 percent of HCP received their infl uenza vaccination. The agency found that during the previous two seasons, fl u vaccination coverage increased by 10 to 12 percentage points from early season to the end of the season. By occupation, early-season fl u vaccination coverage for 2017-2018 was highest among pharmacists (86.4 percent), physicians (82.7 percent), nurses (80.9 percent), nurse practi- tioners/physician assistants (79.7 percent), and other clinical personnel (75.1 percent). Flu vaccination coverage was lowest among administrative and nonclinical support staff (61.0 percent) and assistants and aides (56.2 percent). By work setting, early season fl u vaccination coverage was highest among HCP working in hospitals (82.6 percent). Of concern, fl u vaccination coverage continues to be lower among HCP working in long-term care (LTC) settings (58.5 percent) compared with those working in hospitals and ambulatory-care settings (68.7 percent). Early-season fl u vaccination coverage was higher among HCP whose employers required (88.4 percent) or recommended (65.1 percent) that they be vaccinated compared with HCP whose employer did not have a requirement or a recommendation regarding fl u vaccination (29.8 percent). Among unvaccinated HCP who did not intend to get the fl u vaccination during this fl u season, the most common reason reported for not getting vaccinated was fear of experiencing side effects or getting sick from the vaccine (22.1 percent). The Advisory Committee on Immunization Practices (ACIP) recommends that all HCP receive an annual fl u vaccination. Interventions to promote fl u vaccination among HCP each season include employers offering fl u vaccination to HCP at the worksite over multiple days and shifts, free of charge, and with active promotion. Educational materials should be provided to address questions and misperceptions about fl u vaccination benefi ts and risks. Measurement and feedback of vaccination coverage are recommended to increase uptake of recommended vaccinations. Measures such as the requirements by the Centers for Medicare and Medicaid Services (CMS) for acute-care hospitals, ambulatory surgery centers, and outpatient dialysis facilities to report HCP infl uenza vaccination coverage rates for their facilities may be useful for this purpose. To help guide best practices for healthcare worker immunization, earlier this year the Association of Occupational Health Professionals in Healthcare (AOHP) released a Position Statement on Best Practices for Healthcare Worker Immunizations. AOHP advises that healthcare employers adopt practices ensuring healthcare workers are assessed for immuni- zation status and properly immunized against vaccine-preventable diseases. AOHP's position statement is based on a thorough review of the recommendations of the ACIP, which comprises medical and public health experts who develop recommendations on the use of vaccines in the U.S. civilian population. These recommendations stand as public health guidance for safe use of vaccines and related biological products. "AOHP is committed to promoting recom- mended immunizations for healthcare workers and the Standards for Adult Immunization Practice in healthcare organizations represented by AOHP members," explains AOHP executive president Mary Bliss, RN, COHN. "These vaccines, which protect both healthcare workers and their patients, should be offered at no charge and must comply with state and federal regulations." Specifi c vaccine recommendations included in the AOHP position statement include: ✦ Hepatitis B ✦ MMR - Measles, Mumps, Rubella ✦ Varicella - Chicken Pox ✦ Tdap/Td - Tetanus, Diphtheria, Pertussis ✦ Infl uenza ✦ Neisseria Meningitidis - Meningococcus (Meningitis) In many cases, AOHP recommends that healthcare workers who refuse recommended immunizations should be required to provide a declination statement and not be engaged in direct or indirect patient care. Regarding infl uenza, AOHP advocates that healthcare workers should be vaccinated annually and asks healthcare administrators to consider a policy that makes annual infl uenza vaccination mandatory (with medical exemptions) or offer alternatives to vaccination such as requiring the use of surgical masks for patient care by healthcare workers who refuse the vaccine. ACIP's infl uenza vaccine recommendations: https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specifi c/fl u.html CDC's infl uenza website: https://www.cdc.gov/fl u Resources Vaccination: A Key Weapon in the Occupational Health Arsenal

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